Kasufkin, Richard A
Kasufkin, Richard A is an individual health care provider with primary practice located at 7230 W North Ave Ste 106B Resurrection Immediate Care Center, Elmwood Park IL 60707-4262. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kasufkin, Richard A can be contacted via phone (708) 453-3000.Contact Information
Primary practice address
7230 W North Ave Ste 106B Resurrection Immediate Care Center
Elmwood Park IL 60707-4262
Phone: (708) 453-3000
Fax: (708) 453-4660
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036103195 | Illinois |
Profile Details
NPI number | 1225068240 |
---|---|
LBN Legal business name | Kasufkin, Richard A |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 4th, 2006 |
Last updated | Jun 10th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1225068240 | NPPES |
Illinois | MEDICAID | 3633309286030501 | |
Illinois | MEDICAID | 036103195 | |
Illinois | Other | 1619414 |
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